Self-insured plans covered 31 million participants in 2013, most recent annual report finds

The number of group health plans that self-insured remained relatively stable from 2012 to 2013, according to a recent report from the Department of Labor (DOL). The sixth Annual Report to Congress on Self-Insured Group Health Plans found that approximately 50,200 health plans filed a Form 5500 for 2013, an increase of 2 percent from the health plans that filed a Form 5500 for 2012. Self-insured plans that filed a Form 5500 covered approximately 31 million participants in 2013 and held assets totaling about $77 billion.

Section 1253 of the Patient Protection and Affordable Care Act (ACA) requires the DOL to annually prepare and provide this report to Congress, which contains aggregate information on self-insured employee health plans and financial information on the employers sponsoring the plans. The report is based on plans’ Form 5500 filings.

Plan type. Approximately 19,200 of the self-insured group health plans filing a 2013 Form 5500 were sponsored by a single employer, while 1,100 plans were multiemployer plans. On average, about 47,000 group health plans filed a Form 5500 in the years 2004-2013. While the number of health plans filing a Form 5500 has increased over this period, the fraction of group health plans that are self-insured or mixed-insured has declined somewhat from 55 percent in 2004 to 49 percent in 2013.

Number of participants. In general, plans covering a larger number of participants are more likely to be self-insured than plans with fewer participants. While 51 percent of plans are fullyinsured, only 17 percent of participants are covered by these plans. Between the years 2004 and 2013, an average of 47,000 group health plans, covering an average of 66 million participants, filed a Form 5500 annually.

New plans. Of the approximately 3,000 new health plans filing a 2013 Form 5500, approximately 29 percent were self-insured group health plans, 3 percent were mixed-insured, and 68 percent were fully-insured. Forty-seven percent of the participants in new health plans filing a 2013 Form 5500 were covered under a self-insured group health plan, while 18 percent were in a mixedinsured plan, and 35 percent were covered by a fully-insured plan.

SOURCE: http://www.dol.gov/ebsa/pdf/ACAReportToCongress2016.pdf

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